Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2008 -00357
• COMMUNITY DEVELOPMENT DATE ISSUED: 6/20/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S104BB 07900
SITE ADDRESS: 14300 SW BARROWS RD ZONING: C -C
SUBDIVISION: RUSSELL'S SCHOLLS FERRY SUB LOT : 002 JURISDICTION: TIG •
PROJECT: ALBERTSONS
Project Description: Adding (4) branch circuits for power poles.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HM/ SVC/ FDR: 601 +amps - 1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 3 IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA /SPEC OCC:
Owner: • Contractor:
ALBERTSON'S INC #576 DOUBLE E ELECTRIC INC
PO BOX 20 2626 SE SPRUCE ST
BOISE, ID 83726 HILLSBORO, OR 97123
Phone: Contact #: PRI 503 - 807 - 5156
FAX 503 - 430 -5966
FEES
Description Date -- Amount Reg #: ELE 34 -627C
[ELPRMT] ELC Permit 6/20/2008 $66.80
LIC 152985
[TAX] 12% State 6/20/2008 $8.02 SUP 46205
Total $74.82 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws.
All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is
suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center.
Those rules ar- • h in OAR 952- 001 -0010 through OAR 952 -001 -0100. You may obtain co• : • hese rules or direct questions to OUNC at
503.246.66• • or 1 .800. .2
Issued B , 0 / Permittee � 71 1 • •
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CQAITRACTOR INSTALLATION ONLY
4
SIGNATURE OF SUPR. ELEC'N: % �� �i��� i� DATE:
LICENSE NO:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
'rs
`4.
` Electrical Permit Applicati EI\JE . '- r l l ,' i „ �- r „
��� � h012 Oh 1(E t'S1. OV�L1 `� � ` � '��� `r � � r '
1 f ir � �.,�
e "" 1 Ci o f Tigard QQ Received
Datein _ .� _ _ �' 7
. . , n
13125 SW Hall Blvd, Tigard, OR 97223 1 I 0 ZoO V Plan Review .'
"� Phone: 503.639.4171 Fax: 503.598.1960 Jt1� D Other Permit:
"ii dA,:kD' Inspection Line: 501639.4175 A p D ate Ready/By: tu 61 See Page 2 for
Internet: www.tigardor.gov
CITY OF 1 .
otificdJM _ r Supplemental Information
T Y P E O E 41 i D IN G D 9 � I � 40 ` PLAN REVIEW
0 New construction Add ition /alte ratianirepl acement Please check all that apply (submit 2 sets of plans w! tens checked below):
❑ Demolition ❑Other: ❑ Service or feeder 400 amps or more ❑ Building over three stories.
where the available Pauli current ❑ Marinas and bout, girds.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
Icss to ground, or exceeds 14,000 ❑ Commercial - use agricultural
❑ I - and 2- family dwelling .0 ,12t ornmercial/industrial ❑ AceesSory building amps for all other installations. buildings.
❑ Multi-family ❑ Master builder ❑ Other: 9 Fire pump. ❑ installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ ".A ", "ls ". "I -2 `'1 -3
Job no.: Job site address: 1.43er: � 5U..,S (2 --- _15 lao 10011P or more. occupancy.
� 0 Six or more residential units. 12 Recreational vehicle parks.
City /State /ZIP: 'Ti �e P&JJ, ( 12. ❑ Health - care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg./apt. no.: Project name: 5072 Z tJt\1s , ❑ Service er feeder 600 amps or more.
job site: FEE SCHEDULE
Cross street/directions to
J Description I Qq. I Fee. i Total I •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft or less 145.15 4
Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential
75.00 2
DESCRIPTION OF WORK (with above sq. ft.) _ .
Limited energy, multi - family
75.00 2
PrO0 c 4 1264./Li 7.5 4O Q w X)2 Po (S residential (with above s4. IL)
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 N 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City/State/ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
A. Fee for branch circuits with
❑ APPLICANT i A ab ove service or feeder fee,
❑ CONTACT PERSON 665 2
each branch circuit
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 lei 11 .-
''[ 2
__ first branch circuit
Address: Each add'I branch circuit 4 6.65 r ! 4S 2
' Miscellaneous (service or feeder not included) _
City /State/ZIP: Each manufactured or modular
dwelling, service and /or feeder 90.90 2
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 _ 1 2
• Business name: LJcogc C E. IQ« 4-
Signal panel, on i o n, or
n T energy pane], alteration, or
Address: 'Z(cj� S� SP F 2 � S'C . extension. Describe: Page 2 2
City /State /ZIP: I((..L..5 SO t20 f Ott (9-1( z3 Each additional inspection over allowable in any of the above
p / Per inspection 62.50
Phone: ( 3) '(57 _ 4- E .5-6 Fax: ((b?) 430 - S I ( (D Investigation per hour (1 hr min) 62.50
CCB Lie.: (cZ943s Electrical Lie.: 3447:7C Suprv. Lie.: 4t. S Industrial plant per hour 73.75
� /� ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: >_ I l Q to t IU Subtotal: f $O
Print name: �K5 lrf : iv - I Date: (oil9, l�€ Plan review {25 %ofpermitfee):
State surcharge (12% of permit lice):
Authorized signature: TOTAL PERMIT FEE: - 74- - 17....
Print name: Date: This permit application expires if a permit is not obtained within 180
days after it bas beta accepted as complete.
" Number of inspections allowed per permit.
I: auildmgttcrmits \ELC- Permit.4pp.doc 05123/06 4404615T(111051CONLWEB
L • d 9969 - £09 woJIsN3 pe.id det170 90 66 unr
CITY OF TIGAR,D,. r `
BUILDING DIVISION PERMIT #: E C: 008- 0f1357
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6 /20 /2008
Phone: (503) 639 -4171 0�u
Inspection Requests (24 Hrs.): (503) 639 -4175 e__..
INSPECTION WORKSHEET FOR DATE: 10/17/2008 TIME: 7:02AM PAGE: 36
SITE ADDRESS: 1i3UQ SW BARROWS RD
OF WORK:
SUBDIVISION: RUSSELL'S SCHOLLS FERRY SUB LOT # : 00' TYPE OF USE:
PROJECT NAME: Al l3ERTSONS
DESCRIPTION: Adding (4) branch circuits for power poles.
OWNER: ALf3ERTSON'S INC 76, PHONE #:
CONTRACTOR: DOUBLE E ELECTRIC INC PHONE #: 503-807-5156
Inspection Request Scheduled For: Date: 10/17/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 076835.01 503.607 -5156 N
Corrections /Comments / Instructions:
•
I
PAS I I PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G- NC(?) Date: 0 a � Q 0 Phone #: (503) 7181.1114‘
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2008- 00357
I. 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6!20/2000
Phone: (503) 639 -4171 rdgpu�
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 9/16/2008 TIME: 7:01AM PAGE: 19
SITE ADDRESS: 14300 SW BARROWS RE) CLASS OF WORK:
SUBDIVISION: RUSSELL'S SCHOLLS FERRY SUB LOT #: 002 TYPE OF USE:
PROJECT NAME: ALI3ERTSONS
DESCRIPTION: Adding (4) branch circuits for power poles.
OWNER: ALBERTSON'S INC #576, PHONE #:
CONTRACTOR: DOUBLE E ELECTRIC INC PHONE #: 503 - 8307 -5156
Inspection Request Scheduled For: Date: 9/16/2008 Pour Time:
Code # Inspection Description C.nfirm # Contact # Message
199 Electrical final 075494 -01 503.807 -5156 N
Corrections /Comments /Instructions:
1 •: ®V1 Y Ml • ► N i. c+1 • • _ v , ; ►�(L,
YYNAoki ART 33" B. (s) r D AKS • 300- 11 00
►t & : E t LP B
a :ODE I....P A
The electrical installation defects noted
on this report shall be corrected and
an inspection request made within 20
calendar days per QAR 918 -271 -0030
I I PASS 7 PARTIAL APPROVAL ❑ CANCEL NO ACCESS
. 71 FAIL S CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G— N 6e, Date: 91411 Phone #: (503) 718- J-�